Prof.Etete Peters is the Chief Medical Director of the University of Uyo Teaching Hospital. In this interview with Correspondent, Kazeem Ibrahym,theConsultant Physician speaks on the challenges the hospital is facing and the measures he is taking to counter them. Excerpts:

How do think the country can reduce its mortality rate?

In Nigeria, we still have high maternal mortality rate. Basically, it is because of lack of awareness or accessibility to good health care. You would see some people, either because they don’t have the money to go to the hospital or because they are not totally aware, they still believe that something like HIV/AIDS is not real or there are certain ailments that should not be treated in the hospital.

So, these are the problems that we face. We still have pregnant women, for instance, who will register for antenatal clinic, but when it is time for delivery, they would disappear to the church or to the premises of some native doctors. These are the things that contribute to it. So it requires alot of advocacy that people should come to the hospital. They should not see going to the hospital as a very expensive venture. With the Transformation agenda of President Goodluck Jonathan, all these things are now affordable and they can benefit from the health delivery system. With time, all these things would reduce.

Has the institution complied with the Minister’s directive that cost of dialysis be reduced for more indigenes of the state to benefit from it?

We have complied, although we are still waiting for approval letter to come from the minister. But we have complied as directed. We have also written to the minister to give us a formal approval. We have also initiated contacts with the state government to come and see how the cost of dialysis could be reduced for indigenes of Akwa Ibom, because we believe that as part of the uncommon transformation of the state governor, he has done so much as far as the health sector in the state is concerned. I believe the government should also assist in this aspect too because most of the patients in the state cannot afford the money on a long term basis.

Dialysis is something that that may require two to three sessions a week, lasting for two or three months as the case may be. We have written a proposal to the state government for them to come and subsidise the amount and the governor has promised to look into it.

Apart from the federal and state governments assisting the hospital, where else do you think you can seek assistance?

We sent a proposal to ExxonMobil to assist us at the Trauma Centre and Intensive Care Unit. We have very good Trauma Centre and Intensive Care Unit which are poorly equipped and we need a lot of mechanical ventilators and other equipment to make the place functional. We are expecting and praying that they should respond to the request. As the only tertiary health institution in the state, there is every need for them to support us because we are taking care of the health need of the people. If there is any way the citizens would benefit from Mobil, it would be through this exercise. If we can have a very good functional Intensive Care Unit, it would go a long way in boosting the health need of the people.

We have also written to the Niger Delta Development Commission (NDDC) for support because we have not had any major intervention by the NDDC in the institution. So, we are appealing to them to come in to assist us. We are appealing to them to come and build hostels for doctors, interns, lab scientists and house officers within the premises of the institution. As at now, we have so many interns and a lot of them have been coming from outside town to the hospital, and this poses a lot of problems when they are on call at night. We would appreciate if we can have a standard building that can accommodate up to 30 interns within the premises.

We are also appealing to corporate individuals and well-meaning individuals to come in to assist us. For instance, somebody donated a mothers’ lodge, which is still under construction and would be completed in a few months. So, we are expecting more individuals to come to do something that would enhance the health care delivery system of the state. There are so many things that could be done. We have been appealing to people to come do something even if they want to partner with us in the form of Public-Private-Partnership initiative, because we know that government cannot do it alone.

At the moment, we expect that people should be able to assist the government to ensure that health care delivery is enhanced with better package, because this is the only tertiary institution in the state that takes care of four million people. In some areas, we are forced to take care of primary, secondary and tertiary health because we would not be able to turn back patients. Our facilities are overstretched because of this high number of patients.

Looking at the roads within the institution, how would you finance their construction?

It has been difficult, but this is another area we are calling for assistance. We have made an appeal to the state government to consider us in constructing the internal roads. I still want to believe that His Excellency has plans to do that for us, just

like he did in the University of Uyo. But while we are still waiting for the government, we felt that we should start up something so that patients can walk comfortably within the institution. We still have major areas within the teaching hospital that are not tarred.

What are the major challenges you are facing as the CMD of this institution?

I want to say it is quite enormous. But the major one is in the area of finance. We know generally in the country now that funding has been a little bit difficult. So, as a very young institution that requires a lot of service, we are really bombarded with the need to equip the institution with modern equipment, and the need to put in place infrastructural designs to house the equipment. We have been trying to see how to complete some of the buildings, and by the time we finish them, we would need to equip them with modern gadgets.

It is surprising that we don’t have a CT scan in Akwa Ibom State. It is always embarrassing sending our patients to Umuahia, Port Harcourt or Enugu. You see somebody who is ill and needs to be transported again. It is sad. So, we feel that if we can start from there, it is better, and then we add other things that would make diagnosis of patients and their treatment quite easy. These are some of the problems. Our facilities are overstretched because we have a patients’ load of more than 1,000 daily. And on admission, we have close to 10,000 in a month.

That is really heavy. In fact, in terms of delivery, we now record 20 to 30 on a daily basis. Just like the minister remarked during the last visit, with 100 per cent bed occupancy, where would you keep them? He said maybe the patient would lie on the floor while we search for another space. These are some of the challenges because of the patients’ load. Everywhere is fully occupied, yet you have a lot of patients still hanging around. You feel challenged that there is need to assist these patients. So, we have been working seriously to get some of these structures that would serve as wards

completed for the patients.

Are you suggesting that patients could visit other hospitals in town if the illness is not one they must come to teaching hospital for?

Ideally, that is how it should be. But, you see, it is the mentality of our people. They would tell you they wanted the teaching hospital for whatever reason. A situation where they come to the teaching hospital for minor treatments, we have to treat them. We cannot turn them back. Ideally, health care cases should be at primary, secondary and tertiary levels. The primary and secondary should be able to take care of the common illnesses while more complicated cases should be referred to the tertiary level.

A teaching hospital shouldn’t be where we would start battling with Malaria or normal delivery. But we believe that along the line, with partnership with the state government, we would soon get to that level where we would have enough facilities that can take care of everybody. Here, we don’t discriminate at all because we know the untold hardship that would bring. So, we take care of everybody.

Where do you source for drugs?

We have seen patients lamenting that the drugs they purchase outside are better than the ones at the Teaching Hospital. One thing with drugs is that the quality matters a lot, not only in terms of cost. At UNIUYO Teaching Hospital, we ensure that we stock the right quality of drugs, because we source them directly from the manufacturers. Somebody may go out and say he bought the same drug at a cheaper rate, but you can not trust the quality.

As you know, NAFDAC has been battling the issue of fake drugs, and we as an institution has been encouraging our patients on the need for them to go for the right quality of drugs than to say because of cost they want to buy fake drugs.

The important thing is that in UNIUYO Teaching Hospital, we stock quality drugs for our patients. We have a way of testing for quality drugs here at the teaching hospital.

How would you rate the attitude of health workers to work at the hospital?

We are trying to work on doctors and other health workers to improve on their attitude. What we have also done is to initiate a patient feedback mechanism in that all those who are working in the hospital must always wear their name tags for patients to identify them. Also, we have complaint boxes all over the teaching hospital, and if the complaint is serious, what we do in most cases is to bring the attention of the staff to it for improvement. We also monitor to see the improvement. We also have a lot of ethical training for our members of staff and organise workshops to see how they can improve their attitude. We believe that you may have the right equipment but if you don’t have right calibre of staff in terms of attitude, all those things would be defeated. Patients would not be happy, knowing full well that treatment is faith-based sometimes. If the patient is not happy, no matter the right amount of drugs you give to the patient, he would still not believe in what you have done and, of course, he would not get well.

So, we have been working gradually on this and it has been improving. I keep appealing to the nurses to cooperate with patients, because most of the complaints are about the nurses, so to speak. So, we have been talking to them. Now that people can easily identify them, if there are too many complaints, we can take disciplinary action against you.